Roxane E Kotzin, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9629 Issued in OR

Practice address

4104 SE 82ND Ave Ste 450
Portland, OR 97266-2958

Phone

(503) 771-4324

Fax

(503) 771-4458

NPI assigned

Sep 29, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1174807861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 NE CAMPUS WAY",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971245611",
            "telephone_number": "503-952-2125",
            "fax_number": "503-952-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4104 SE 82ND AVE STE 450",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972662958",
            "telephone_number": "503-771-4324",
            "fax_number": "503-771-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTZIN",
        "first_name": "ROXANE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-29",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Kotel, DPT
• Lara Lynn Kotelyanets, SRNA
• Jay S Kothari, M.D.
• Kelsey Kotsovos
• Alexander Kotukhov, MD
• Yuqing Kou, L.AC.
• Louis Jonathan Kouch, PHARM.D.
• Cecilia Koukoumanos
• Madeline Katherine Koulouris-McCarver, RN
• Katrina Kountz

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.